Multicentre clinical trial to evaluate microbial spectrum in acute diffuse otitis externa in the residents of Ukraine

Introduction: Acute diffuse otitis externa is a spread skin inflammation of the external ear canal of the bacterial origin. It is reported at an incidence of up to 10% among healthy population of all age groups. Treatment is known to be based on the empirical approach for prescribing topical antibacterials. Therefore studying the bacterial spectrum of otitis externa causative agents is of great value in terms of relevant antimicrobial therapy. Aim: The objective of the study was to evaluate microbial spectrum in diffuse otitis externa in patients – residents of Ukraine. Materials and methods: Four hundred and ninety-three out-patients diagnosed with acute diffuse otitis externa were enrolled. Microbial composition of the external ear canal microflora was tested and aetiologically relevant titres of colony-forming units (CFU) were determined. Criteria for evaluation: titres of 104 to 106 CFU and >106 CFU were considered aetiologically relevant. titres of <104 CFU were considered aetiologically nonrelevant. Results and discussion: In the majority of cases of acute diffuse otitis externa, infection with Staphylococcus aureus in aetiologically relevant titres is reported in 53.2% and Pseudomonas aeruginosa in 23.6%. Cases of multimicrobial infection predominantly involving Gram-negative flora were also reported in 27.9%; each of them results in no more than 2 to 3% of otitis externa. Titres of Candida spp. (3.2%) and Staphylococcus epidermidis (2.6%) were measured as aetiologically non-relevant. Conclusion: common microbial pathogens in acute diffuse otitis externa in patients of the Ukrainian population are Staphylococcus aureus and Pseudomonas aeruginosa. Multimicrobial associations predominantly involving Gram-negative flora, which do not exceed 2 to 3% of cases. Fungal infections are a rare cause of otitis externa.

Phenotypic identification of soil bacterial and fungal communities inhabiting an archaeological monument at Augustine University, Ilara Epe, southwest Nigeria

Background: The Sungbo Eredo Monument is an ancient public work with a system of defensive walls and ditches located in Eredo Local Council Development Area of Epe, Lagos State, southwest Nigeria. A huge section of the monument cuts through the Augustine University campus, forming two-sided vertical walls with a deep ridge in-between. The objective of this investigative study is to determine the microbial profile of soil samples from the monument in the University campus. Methodology: Soil samples were collected from the topsoil at a depth of 7.5cm from four randomly selected points along the edge of the monument. The samples were transported to the microbiology laboratory of the Department of Biological Sciences of Augustine University for analysis. Samples were cultured on Nutrient agar (NA) and incubated aerobically for 24-48 hours for bacteria isolation and on Sabouraud’s Dextrose agar (SDA) for 72 hours for fungi isolation. Bacterial colonies on NA were preliminarily identified to genus level by Gram reaction and conventional biochemical test scheme for Gram-positive (catalase, coagulase, starch hydrolysis) and Gram-negative isolates (oxidase, urease test, indole, methyl red, Voges Proskauer and sugar fermentation tests). Fungi colonies on SDA were identified using conventional macroscopic and microscopic characteristics. Antibiotic susceptibility test of the bacterial isolates to selected antibiotics was done using the Kirby Bauer disc diffusion method. Results: A total of twenty-three bacterial isolates in four genera; Bacillus, Staphylococcus, Cellobiococcus and Micrococcus and nine fungal isolates in three genera; Saccharomyces, Aspergillus and Botrytis were identified from the cultures. The bacterial isolates were sensitive (>50% sensitivity) to only gentamicin and ofloxacin, with 65.2% and 78.3% sensitivity rates respectively, while they were largely resistant to all other antibiotics such as ceftriaxone, erythromycin, cefuroxime, cloxacillin, ceftazidime and augmentin, with resistance rates of 65.2%, 65.2%, 73.9%, 82.6%, 86.9%, 91.3% respectively. Conclusion: The results of this investigative study revealed the presence of antibiotic-resistant bacteria (mainly Gram-positive) and fungi on the archaeological monument of Augustine University, adding to the existing data on microbial spectrum of archaeological monuments that could be useful for unraveling human cultural habits and microbe-related human diseases. However, further studies on molecular identification of these microbial spectrum will be required to ascertain their genetic relatedness and ancestral phylogeny, which will be useful for archaeologists in their study of the Sungbo-Eredo ancestral monument. French title: Identification phénotypique des communautés bactériennes et fongiques du sol habitant un monument archéologique à l'Université Augustine, Ilara Epe, sud-ouest du Nigeria Contexte: Le monument Sungbo Eredo est un ancien ouvrage public doté d'un système de murs défensifs et de fossés situé dans la zone de développement du conseil local d'Eredo à Epe, dans l'État de Lagos, au sud-ouest du Nigéria. Une énorme section du monument traverse le campus de l'Université Augustine, formant des murs verticaux à deux côtés avec une crête profonde entre les deux. L'objectif de cette étude d'investigation est de déterminer le profil microbien d'échantillons de sol provenant du monument du campus universitaire. Méthodologie: Des échantillons de sol ont été prélevés dans la couche arable à une profondeur de 7,5 cm à partir de quatre points choisis au hasard le long du bord du monument. Les échantillons ont été transportés au laboratoire de microbiologie du Département des sciences biologiques de l'Université Augustine pour analyse. Les échantillons ont été cultivés sur gélose nutritive (NA) et incubés en aérobie pendant 24 à 48 heures pour l'isolement des bactéries et sur gélose au dextrose de Sabouraud's(SDA) pendant 72 heures pour l'isolement des champignons. Les colonies bactériennes sur NA ont été préalablement identifiées au niveau du genre par réaction de Gram et schéma de test biochimique conventionnel pour les isolats Gram-positif (catalase, coagulase, hydrolyse de l'amidon) et Gram-négatif (oxydase, test à l'uréase, indole, rouge de méthyle, Voges Proskauer et sucre essais de fermentation). Les colonies de champignons sur SDA ont été identifiées en utilisant des caractéristiques macroscopiques et microscopiques conventionnelles. Le test de sensibilité aux antibiotiques des isolats bactériens à des antibiotiques sélectionnés a été effectué en utilisant la méthode de diffusion sur disque de Kirby Bauer. Résultats: Un total de vingt-trois isolats bactériens dans quatre genres; Bacillus, Staphylococcus, Cellobiococcus et Micrococcus et neuf isolats fongiques de trois genres; Saccharomyces, Aspergillus et Botrytis ont été identifiés à partir des cultures. Les isolats bactériens étaient sensibles (sensibilité >50%) uniquement à la gentamicine et à l'ofloxacine, avec des taux de sensibilité de 65,2 % et 78,3 % respectivement, alors qu'ils étaient largement résistants à tous les autres antibiotiques comme la ceftriaxone, l'érythromycine, la céfuroxime, la cloxacilline, la ceftazidime et l'augmentine avec des taux de résistance de 65,2%, 65,2%, 73,9%, 82,6%, 86,9%, 91,3% respectivement. Conclusion: Les résultats de cette étude d'investigation ont révélé la présence de bactéries résistantes aux antibiotiques (principalement à Gram positif) et de champignons sur le monument archéologique de l'Université Augustine, ajoutant aux données existantes sur le spectre microbien des monuments archéologiques qui pourraient être utiles pour démêler l'homme. les habitudes culturelles et les maladies humaines liées aux microbes. Cependant, d'autres études sur l'identification moléculaire de ces spectres microbiens seront nécessaires pour déterminer leur parenté génétique et leur phylogénie ancestrale, ce qui sera utile aux archéologues dans leur étude du monument ancestral Sungbo-Eredo.

A study of Ascitic Fluid of Cirrhotic patients with Spontaneous Bacterial Peritonitis; common microorganisms and their antibiotic Senstivity

Background: Spontaneous bacterial peritonitis (SBP) is an acute infection of otherwise sterile ascitic fluid in patients with decompensated liver cirrhosis. Gram negative bacteria are considered the main causative microorganisms of SBP. However, widespread use of antibiotics in cirrhotic patients has changed the microbial spectrum and the sensitivity patterns. Aim: To determine the frequency of different microorganisms and their sensitivity patterns in ascitic fluid of cirrhotic patients with spontaneous bacterial peritonitis and to see the impact of age, gender and duration of SBP on these patterns. Study design and duration: It was a prospective observational study conducted at Fatima Memorial Hospital, Lahore from December 2015 to December 2016. Methods: A total of 200 patients with clinical suspicion of SBP were enrolled in the study. Ascitic fluid sample was obtained within 6 hours of hospitalization and was sent to hospital laboratory. Culture reports were reviewed to determine the frequency of different microorganism as well as their sensitivity patterns to different antibiotics. Results: Out of 200 patients, the culture was positive in 113(56.53%) patients. Escherichia coli was seen in 35 (31.2%) patients, Acinobacter Spp was present in 18 (15.3%), Streptococcus in 15 (13.4%), Enterococcus in 14 (12.1%), Staphylococcus aureus in 13 (11.4%), MRSA in 12 (10.8%), and K. Pneumonia in 6 (5.7%) patients. Ceftazidime was sensitive in 73 (64.9%) cases, Cefotaxime was sensitive in 55 (49%), Ceftriaxone was sensitive in 50 (43.9%), Ciprofloxacin was sensitive in 49 (43.3%), Amikacin was sensitive in 36 (31.8%) Conclusion: The most frequent organism in ascitic fluid of SBP patients was E Coli, and the most sensitive antibiotic was ceftazidime. Keywords: Microbial Spectrum, Sensitivity Pattern,Spontaneous Bacterial Peritonitis (SBP), Ascitic Fluid

Endophthalmitis Panorama in The Jerusalem Area

Purpose: The spectrum of microbial infections and the pattern of their susceptibility is variable among communities. Researching this data will lead to the establishment of the most appropriate national management strategies. The purpose of this study was to analyze the epidemiological, clinical, microbial spectrum and antibiotic susceptibility of endophthalmitis cases in a tertiary referral center in Jerusalem.Methods: Retrospective review of medical charts of patients presenting with endophthalmitis over a 12-year-period.Results: Included were 74 eyes of 70 patients (males 56%). Mean age±SD at presentation was 60±19.5 years. Exogenous endophthalmitis accounted for 78% of cases; of which, 62% followed an intraocular surgery, 21% occurred after intravitreal injections, 10% followed infectious keratitis and 7% were post-traumatic. Endogenous cases were predominantly observed in diabetic patients. Microbial isolates were identified in 44 samples. Of them, gram-positive bacteria were the predominant microorganisms detected in 33 samples (75%); Staphylococcus epidermidis and Enterococcus faecalis were the most commonly detected pathogens. Mean presenting±SD LogMAR visual acuity (VA) was 2.38±1.21 and it improved at last follow-up to 1.7±1.37 (p=0.004, paired t-test). Cases secondary to gram-positive microbes were associated with improved VA during the follow-up while cases secondary to gram-negative microbes was correlated with poor final VA (p=0.046, r2=0.4). There was no evidence of bacterial resistance in the antibiograms for either vancomycin, ceftazidime, ceftriaxone or amikacin.Conclusions: Intraocular surgery remains the most common event preceding endophthalmitis with coagulase-negative staphylococci being the most frequently detected microorganisms. The microbial spectrum of endophthalmitis is similar to that in the western world.

FEATURES OF VIOLATIONS OF THE STATE OF THE VAGINAL ECOSYSTEM IN PREGNANT WOMEN WITH BACTERIAL VAGINOSIS

The aim: To assess the condition of the vaginal ecosystem in pregnant women with BV. Materials and methods: The main group consisted of 60 pregnant women with BV in the II trimester. The bacterioscopic examination, of vaginal smears was carried out. DNA diagnostics of the microbial spectrum of vaginal contents was performed. Bacteria with biofilm were visualized by fluorescence hybridization in situ. Results: Biofilms were found in 25 women (41.65%) of the main group, the main component of which was bacteria belonging to the Gardnerella cluster at a concentration of 7.9 ± 0.13 log CFU/ g. Atopobium vagine cluster bacteria gave positive hybridization signals in more than half of the patients and amounted to 6.8 ± 0.15 lg CFU / g. In addition, Snethia spp. was determined as a part of the biofilm at a concentration of 5.8 ± 0.3 lg CFU / g. Conclusions: Thus, the use of the proposed treatment regimen for women with vaginal dysbiosis led to the elimination of pathogenic and conditionally pathogenic microflora. However, the effectiveness of treatment in 5 cases was lower than expected, which indicates the emergence of bacterial resistance.